ABCDEFalls ReminderMatthew ForbesFoundation Year 2

Why?

Falls account for

30% of patient

safety incidents

reported to the

NRLS

Falls cost the NHS £15 million annually

Many falls are

unacceptable and

preventable by

modifying behavioural

or environmental

factors

HousekeepingHousekeeping

“Someone should check the floors every half an hour”“Someone should check the floors every half an hour”

“If someone is incontinent on the floor clean it up immediately”“If someone is incontinent on the floor clean it up immediately”

“Make sure clutter is removed from around the bed”“Make sure clutter is removed from around the bed”

Ward organisationWard organisation

“Ensure patients who are at high risk are placed near the nurses station”“Ensure patients who are at high risk are placed near the nurses station”

“Planning staffing around when people are more likely to fall”“Planning staffing around when people are more likely to fall”

“Staff being more aware of where patients are and what they are doing”“Staff being more aware of where patients are and what they are doing”

BBBBBBBB

CommunicationCommunication

“Make sure the patient knows how to ask for help e.g. to go to the toilet”“Make sure the patient knows how to ask for help e.g. to go to the toilet”

“Take a step back and educate people when they are younger about falls”“Take a step back and educate people when they are younger about falls”

“Treat patients as individuals”“Treat patients as individuals”

Some of the

interventions

suggested by

our

interviewees

Some of the

interventions

suggested by

our

interviewees

EquipmentEquipment

“Make sure alarm bells are within patients’ reach”“Make sure alarm bells are within patients’ reach”

“Adjustable height seating with built in pressure relief”“Adjustable height seating with built in pressure relief”

“Individualised seating”“Individualised seating”

“Make sure patients with catheters have leg bags”“Make sure patients with catheters have leg bags”

“Avoid unnecessary catheters”“Avoid unnecessary catheters”

“Custom lengths of catheters”“Custom lengths of catheters”

“Less slippery footwear”“Less slippery footwear”

“Elasticated or better fitting pyjamas”“Elasticated or better fitting pyjamas”

“Mend any broken glasses”“Mend any broken glasses”

“Ensure patients have their glasses”“Ensure patients have their glasses”

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Brice S, Long S, Forbes M, Shanley R, Vincent C, Woloshynowych M. Identifying risks to older patients – a scoping exercise. A report for the Dunhill Medical Trust. 2009.

Assessment and care planningAssessment and care planning

“One to one care if delirious”“One to one care if delirious”

“Continence assessments”“Continence assessments”

“Referring to OT and physio quickly”“Referring to OT and physio quickly”

“Better collateral history”“Better collateral history”

“Thinking more about the needs of the individual”“Thinking more about the needs of the individual”

Ward environmentWard environment

“Ensure patient’s aids have name labels”“Ensure patient’s aids have name labels”

“Lighting the floor to reduce glare”“Lighting the floor to reduce glare”

“Better lighting”“Better lighting”

“Signage pointing the route to the toilet”“Signage pointing the route to the toilet”

What?

AAAA larm bell

BBBBed location

CCCCatheter

DDDDress

EEEEyewear

Falls Reminder

ABCDEFalls reminder

Eyewear

Dress

Catheter

Bed location

Alarm bell

Item

If the patient is mobile and has a

catheter have you considered giving

them a leg bag?

Does the patient have poor

eyesight? Do they have their

glasses with them and are they

easily accessible to them? Are they

in working order?

Do they have appropriate fitting

pyjamas/nightgowns? Do they have

appropriate fitting footwear?

Have you thought about the best

location for the patient on the ward?

Should they be moved nearer to the

nursing station?

Does the patient know how to ask

for help? Do they have a call bell;

know where it is and how to use it?

Considerations

How?

Engagement

Falls reminder

Feedback

ABCDE

Strategyfor

change

Assess impact

Outcomes

This is a cost effective

addition to existing care

processes and

interventions, whose

benefits far outweigh

the extra time required

and cost

Acknowledgements

• Susy Long & Sarah Brice, Centre for Patient Safety and Service Quality, Imperial College London

• David Morrow- Illustrations